Health Outcomes Research in Medicine
Volume 2, Issue 4 , Pages e215-e226, November 2011

Costs of Sequelae Associated with Invasive Meningococcal Disease: Findings from a US Managed Care Population

  • Sudeep Karve, PhD

      Affiliations

    • Health Economics – United States, RTI Health Solutions, Research Triangle Park, NC
    • Corresponding Author InformationCorresponding Author: Sudeep Karve, PhD, RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC 27709.
    • ,
  • Derek Misurski, PhD

      Affiliations

    • Global Health Outcomes; GlaxoSmithKline, Philadelphia, PA
    • ,
  • Jacqueline Miller, MD

      Affiliations

    • Global Vaccine Development; GlaxoSmithKline, King of Prussia, PA
    • ,
  • Keith L. Davis, MA

      Affiliations

    • Health Economics – United States, RTI Health Solutions, Research Triangle Park, NC

published online 25 August 2011.

Abstract 

Objectives

To assess health care utilization and costs among patients experiencing invasive meningococcal disease (IMD)-related sequelae compared with IMD patients without sequelae.

Study Design

A retrospective cohort analysis of an administrative claims database for years 1997-2009. Patients with IMD-related inpatient admissions and continuous health plan enrollment were selected and categorized by the presence (complicated IMD) or absence (uncomplicated IMD) of IMD-related sequelae during the 12-month follow-up period. Univariate and multivariable analyses assessed differences in health care utilization and related costs between the 2 patient groups.

Results

We identified 343 patients; 117 (34%) had a diagnosis claim for at least one IMD-related sequela during the follow-up period. Multivariable analyses showed significantly higher total health care costs for complicated IMD cases (mean: $96,826; 95% confidence interval: $88,659-$104,993) compared with uncomplicated IMD cases (mean: $32,414; 95% confidence interval: $30,825-$34,003). Risk of rehospitalization after initial IMD admission was higher for patients with complicated IMD (hazard ratio = 1.7; 95% confidence interval: 1.0-2.7; P = .034) compared with patients with uncomplicated IMD.

Conclusion(s)

Predicted health care costs among patients with complicated IMD were 3 times higher compared with patients with uncomplicated IMD. These costs should be considered when economic evaluations of meningococcal vaccination programs are made.

Keywords: Economic burden, Health care utilization, Invasive meningococcal disease

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 Funding for this study was provided by GlaxoSmithKline. GlaxoSmithKline also is conducting clinical research in meningococcal disease. The publication of the study results is not contingent upon the sponsors’ approval or censorship of the manuscript. Sudeep Karve, Keith Davis, and Derek Misurski were the primary developers of the study design. As principal investigator, Sudeep Karve had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Keith Davis and Sudeep Karve led all statistical analyses. Sudeep Karve also served as the primary writer in drafting the manuscript text and in interpreting the findings. Derek Misurski also assisted in obtaining the study data. Derek Misurski and Jacqueline Miller assisted in interpreting the study findings and drafting the manuscript text; they also served as the primary reviewers of the manuscript text. All authors were responsible for approving the manuscript and its contents.

 Sudeep Karve and Keith Davis are employees of RTI Health Solutions, an independent contract research organization that has received research funding from GlaxoSmithKline for this study. Derek Misurski and Jacqueline Miller are GlaxoSmithKline employees and shareholders.

PII: S1877-1319(11)00026-7

doi:10.1016/j.ehrm.2011.08.001

Health Outcomes Research in Medicine
Volume 2, Issue 4 , Pages e215-e226, November 2011

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